Non-Hodgkin's Lymphoma
Screening, Diagnosis and Medical Tests
Physical Examination and Anamnesis
One of the first steps in the screening process is an anamnesis where
past health problems are discussed, all risk factors are covered and the
present health state is investigated. The doctor will try to get a detailed
perspective on possible infections, health problems or lymphoma symptoms.
Afterwards, the doctor will closely examine both the swollen nodes and
the other lymph nodes to determine their size, location, tenderness, and
consistency.
Blood and urine
tests
Another step in the diagnosis procedure is blood and urine tests.
When a lymphatic node swells, it is a sign that your body is fighting
an infection. Therefore, the doctor will take a sample of blood
and urine to establish the infection parameters and determine the
causes of the infection.
X-Ray, Computer Tomography (CT) and Positron Emission
Tomography (PET)
If the inflammated lymph nodes are in the chest area, they can
be seen in a plain chest x-ray. If a tumor is visible on the x-ray,
the doctor will follow with a CT scan in order to obtain a better
image of the tumor. The CT scan is an advanced x-ray procedure
that produces a more detailed cross-sectional image of the body.
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The CT scan procedure involves two phases: in the first phase, a first
set of pictures will be taken and in the second phase, the patient will
receive an intravenous injection (IV) of a radiocontrast agent in order
to better outline the structure of the body and a second set of pictures
will be taken. The two groups of images are then compared to each other.
Your doctor may also order a Positron Emission Tomography, or PET scan.
This procedure is a new type of radioactive scan. A special glucose substance
that contains a radioactive atom is administered to the patient and a
special camera will detect radioactivity. Lymphoma cells have a
high rate of metabolism that absorbs a high amount of radioactive sugar.
This procedure is effectively used in detecting non-Hodgkin’s lymphoma.
It is often implemented after treatment to ascertain if any tumors remain.
Biopsies
There are several types of biopsies available in order to determine the
stage of the cancer. When the doctor recommends a biopsy, the diagnosis
procedure passes into the second phase of this process.
The first two steps (anamnesis, physical examination, and then x-ray,
CT scan and PET scan) are decisive in establishing if there is a form
of cancer or not. The role of the next procedure is to determine the cancer
type, the cancer stage and other indicators necessary to establish a treatment
plan.
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Fine needle aspiration (FNA) biopsy.
This procedure involves taking a sample of cells from the swollen
lymphatic node using a thin needle attached to a syringe. When the
swollen lymph node is right under the skin and palpable, the needle
is then inserted directly into the node. If the lump is deep within
the body, this procedure is performed with the help of a CT scan,
ultrasound or other imagining techniques. This biopsy can determine
noncancerous conditions from different forms of cancer and establish
the cancer staging or monitor recurrence or return of cancer.
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Large needle/core biopsy. This procedure
involves taking a sample of tissue from the tumor. It is not a commonly
diagnosing procedure and it is used just for those patients that cannot
tolerate invasive surgical procedures. Like FNA, core biopsy is performed
under a CT scan, ultrasound and other imagine techniques.
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Surgical biopsy. There are two types
of surgical biopsies: incisional biopsies, when a
small piece of a large tumor is removed for examination and excisional
biopsies, when the small size tumor is removed completely.
Both types of surgical biopsies procedures are performed under local
or total anesthesia. Biopsy procedures can be used to remove tissue
from a lymph node or from the bone marrow. The lymph node biopsy provides
important information about the progressive rate of the cancer.
Bone Marrow Tests
A bone marrow biopsy is necessary if there are concerns that the disease
spread. The bone marrow is drawn up through a thin needle that is inserted
into the pelvic bone. Once the bone marrow is extracted, it will be examined
by different specialists (pathologist – the disease diagnosis specialist,
hematologist – the blood specialist, and oncologist – the cancer
specialist). These tests are used to establish the cancer staging.
Lumbar Puncture
A lumbar puncture or spinal tap procedure can tell doctors if the cancer
has spread to the central nervous system. The puncture is made with a
thin needle inserted in the lumbar backbone below the level of spinal
cord and a sample of cerebrospinal fluid is withdrawn. This sample then
is analyzed for the number of the lymphocytes cells.
Article by Alina Morrow, MS
Medical Writer
OmniMedicalSearch.com
Page Covers: What are the tests for Non-Hodgkin's Disease?
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